In 2015 (the most recent year for which data are available),
the U.S.
Census Bureau estimates that only 2.8 percent—189,000
people—in Massachusetts did not have health insurance
coverage. This rate has been falling over the past few years (see
chart).

Health reform at the national level has had a significant impact on
health insurance coverage rates for other states. In fact, more than 15
million fewer people nationally are now uninsured compared to 2013 when
key provisions of national health reform started to take effect.

In particular, many other states that have taken advantage of the
federal funding available to expand their Medicaid coverage have seen
dramatic increases in health care coverage from 2013 to
2015—by more than 8 percentage points in some states (see
chart).

Health reform has not only brought greater access to health
care for
thousands of people across the Commonwealth, it also has provided an
important financial boost for the state. Thanks to national health
reform, the federal government is now providing hundreds of millions in
federal funding for health care costs previously paid for by the state.

How the Census Bureau Measures Health Insurance

The data above are from the American Community Survey. The Census
Bureau releases two major surveys that measure health insurance
coverage: the Current Population Survey (CPS) and the American
Community Survey (ACS). These two surveys measure health insurance
coverage in slightly different ways, and can have slightly different
results.

The CPS has been measuring health insurance coverage since 1987,
alongside employment statistics from the U.S. Bureau of Labor
Statistics. This survey provides important information for historic
trends. However, the Census Bureau changed the health insurance
questions in 2013, so information prior to that year should no longer
be compared to information since then.
Since 2008, the Census Bureau included questions about health insurance
in the ACS. The ACS uses a much larger sample size than the CPS, so
health insurance statistics are available from the ACS for states,
counties, and even smaller geographic regions.

The two surveys also measure health insurance coverage in slightly
different ways. In the spring, the CPS asks respondents if they had
health insurance at any time in the previous calendar year. Someone is
“uninsured” in the CPS only if that person reports
having no coverage under any type of health insurance during that time
period. The ACS, on the other hand, is a survey conducted over the
course of the year. The ACS asks respondents if they are covered by any
of the types of listed health insurance (public, private, etc.) Someone
is “uninsured” in the ACS if that person reports
have no coverage at the time of the survey.

Massachusetts Budget and Policy Center

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